DR. KIMBERLY SUE JOHNSON (NPI# 1467682971) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467682971 |
| Entity Type | Individual |
| Full Name | DR. KIMBERLY SUE JOHNSON |
| Credential | M.D. |
| Practice Address |
416 Connable Ave Petoskey MI 49770-2212 |
| Mailing Address |
3400 N Center Rd Suite 400 Saginaw MI 48603-7919 |
| Practice Telephone | 3124874180 |
| Mailing Telephone | 9897539000 |
| Enumeration Date | 2009-07-17 |
| Last Update Date | 2019-06-27 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
4301094869 | MI | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023619020 | Kimberly Little Johnson | Physical Therapy Assistant | 7913 Red Globe Ct, Severn, MD 21144-1047 | 2020-11-05 |
| 1770198657 | Kimberly Ann Johnson | Technician | 171 Teal Rd, Martinsburg, WV 25405-8946 | 2020-09-09 |
| 1255940698 | Kimberly Renee Johnson | Clinical Exercise Physiologist | 5645 Danvers Rd, Portsmouth, VA 23703-3730 | 2020-07-30 |
| 1932722014 | Kimberly Lashonda Johnson | Counselor | 2018 James Overlook Dr, Chester, VA 23836-2851 | 2020-05-22 |
| 1164051850 | Kimberly L Johnson | Home Health | 14055 46th Street North Suite 1102, Clearwater, FL 33762 | 2020-04-03 |
| 1255965596 | Kimberly Ann Johnson | Occupational Therapy Assistant | 16512 Honeybunch Ln Se, Oldtown, MD 21555-1325 | 2020-02-25 |
| 1043788706 | Kimberly Johnson | Occupational Therapist | 8870 Youree Dr Ste 108, Shreveport, LA 71115-2512 | 2018-11-10 |
| 1750866992 | Kimberly Johnson | Driver | 3030 Marcia Louise Dr, Southaven, MS 38672-6750 | 2018-10-02 |
| 1801399928 | Kimberly Johnson | Chiropractor | 487 N Turnpike Rd, Santa Barbara, CA 93111-1955 | 2018-03-15 |
| 1598280984 | Kimberly Sue Johnson | Nurse Practitioner | 1201 7th St Se Ste 120, Decatur, AL 35601-3337 | 2017-08-07 |
| Street Address |
416 CONNABLE AVE |
| City | PETOSKEY |
| State | MI |
| Zip Code | 49770-2212 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073512687 | Michael A Angileri | Radiology | 416 Connable Ave, Petoskey, MI 49770-2212 | 2005-07-15 |
| 1023619483 | Bay Radiation Oncology, Pllc | Radiology | 416 Connable Ave, Petoskey, MI 49770-2212 | 2020-11-03 |
| 1972116895 | Cameron P Burns | Nurse Practitioner | 416 Connable Ave, Petoskey, MI 49770-2212 | 2020-08-29 |
| 1447878566 | Tiffany Hornbeck | Registered Nurse | 416 Connable Ave, Petoskey, MI 49770-2212 | 2020-07-07 |
| 1083231963 | Cory Mills | Registered Nurse | 416 Connable Ave, Petoskey, MI 49770-2212 | 2020-06-26 |
| 1508417031 | Alexander Joseph Perry | Registered Nurse | 416 Connable Ave, Petoskey, MI 49770-2212 | 2019-09-25 |
| 1699332668 | Murphy Gillespie | Nurse Practitioner | 416 Connable Ave, Petoskey, MI 49770-2212 | 2019-05-24 |
| 1407322985 | Shanna Macclaren | Nurse Practitioner | 416 Connable Ave, Petoskey, MI 49770-2212 | 2018-10-22 |
| 1730664186 | Emily Powell | Occupational Therapist | 416 Connable Ave, Petoskey, MI 49770-2212 | 2018-10-02 |
| 1831673458 | Mary Ford | Occupational Therapist | 416 Connable Ave, Petoskey, MI 49770-2212 | 2018-09-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780231985 | Olivia Michelle Seaman | Pharmacist | 1301 U.S. 31 N. Hwy, Petoskey, MI 49770 | 2019-08-22 |
| 1649733148 | Harbor Hall, Inc. | Clinic/Center | 302 Orchard Ridge Drive, Petoskey, MI 49770 | 2019-04-11 |
| 1053802942 | Devin Hueston | Dentist | 231 State St Ste 3, Petoskey, MI 49770 | 2018-05-25 |
| 1720585037 | Jacob Kenneth Tracy | Counselor | 410 E Lake Street, Suite 100, Petoskey, MI 49770 | 2018-04-12 |
| 1013424191 | Timothy Robert La Gasse | Nurse Practitioner | 401 Connable Ave, Petoskey, MI 49770 | 2018-01-10 |
| 1609303676 | Shauna Sue Stark | Nurse Practitioner | 560 W Mitchell St Ste 505, Petoskey, MI 49770 | 2017-05-22 |
| 1053851519 | Maureen Todd | Counselor | 703 Emmet St, Petoskey, MI 49770 | 2017-03-03 |
| 1457719239 | Hufford Vision & Eye Care, PC | Optometrist | 560 West Mitchell, Suite 214, Petoskey, MI 49770 | 2016-02-08 |
| 1053779439 | Kaylyn Schiemann | Specialist/Technologist | 1980 Maxwell Rd, Petoskey, MI 49770 | 2016-02-01 |
| 1669839130 | Stieber Pediatric Dentistry Pllc | Clinic/Center | 1605 Us 131 Highway, Petoskey, MI 49770 | 2016-01-28 |
| Find all providers in zip 49770 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336626696 | Quantum Medical Radiology of California, P.C. | Radiology | 1625 Bear Creek Ln Unit O, Petoskey, MI 49770-8378 | 2018-07-19 |
| 1578529178 | Stanley R Smith | Radiology | 330 E Mitchell St, #210, Petoskey, MI 49770-2671 | 2006-04-22 |
| 1073512687 | Michael A Angileri | Radiology | 416 Connable Ave, Petoskey, MI 49770-2212 | 2005-07-15 |
| 1073950945 | Andrew Osetek | Radiology | 416 Connable Ave, Petoskey, MI 49770-2212 | 2013-05-31 |
| 1043446834 | Nel Rainier Go | Radiology | 416 Connable Ave, Petoskey, MI 49770-2212 | 2009-06-07 |
| 1184843781 | Michael William Kuhn | Radiology | 416 Connable Ave, Petoskey, MI 49770-2212 | 2007-04-24 |
| 1477604874 | Ryan R. Hoenicke | Radiology | 416 Connable Ave, Petoskey, MI 49770-2212 | 2007-01-15 |
| 1497775514 | Bradley T Vanassche | Radiology | 1114 Charlevoix Ave, Petoskey, MI 49770-9701 | 2006-07-20 |
| 1811924160 | Matthew L Visconti Md LLC | Radiology | 1114 Charlevoix Ave, Petoskey, MI 49770-9701 | 2006-06-26 |
| 1306883202 | Matthew L Visconti | Radiology | 1114 Charlevoix Ave, Petoskey, MI 49770-9701 | 2006-05-31 |
| Find all providers in PETOSKEY | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.